Healthcare workers struggled with their own fears of the COVID-19 pandemic while trying to save lives. (Art by Lindsay Mound)Collection from The Nocturnists Documents Challenges Healthcare Workers Faced as Pandemic EvolvedThe Library of Congress has acquired audio diaries featuring more than 200 frontline healthcare workers in the fight against COVID-19, a collection that provides first-hand testimonies from hospitals and communities across the country as the public health crisis unfolded. The audio library was donated by The Nocturnists, a San Francisco-based independent medical storytelling community and podcast.The majority of the recordings were originally collected for the “Stories from a Pandemic” series in the spring of 2020, of which only a small fraction was published on the podcast and accompanying online story map. The gift also includes the pandemic-related material from The Nocturnists’ “Black Voices in Healthcare” series, which was recently selected as a podcast honoree in the 2021 Webby Awards. Additionally, the group plans to donate recordings collected for the follow-up series, “Stories from a Pandemic: Part 2”, launching today on The Nocturnists podcast.The “Stories from a Pandemic” archive, a unique on-going collection of well over 700 audio clips to date, helps describe the “inner landscapes” of doctors, nurses, and other health care practitioners — some of whom worked the overnight shift — as they faced what the CDC has called the country’s worst public health crisis in a century. In fact, COVID-19 was the third leading cause of death in the U.S. last year, and more Americans have died after contracting the virus than in both World Wars and the Vietnam War combined.As the nation begins to crawl back to normalcy amid a massive vaccination effort, the collection of audio diaries serves as a reminder of the impact COVID-19 has had on the healthcare system, the economy, education, world commerce and daily life in America. But the collection also offers testimonies about what normalcy may look like at home and in the workplace, going from fear and anxiety to hope and optimism.“The Nocturnists’ collection is full of intimate, real-time stories from medical practitioners at the beginning of the COVID-19 pandemic, confronting the human toll on their patients, themselves and their communities. You hear the sounds of the workplace, the exhaustion in their voices, and the big and small ways they try to cope and contribute; it’s really a remarkable gift,” said Elizabeth Peterson, director of the American Folklife Center at the Library of Congress.The American Folklife Center, which will house and preserve this digital archive, has been collecting oral histories from different groups and communities since 1976. The collections include interviews with civil rights leaders, as well as first-hand accounts from 9/11 first responders, survivors from hurricanes Katrina and Rita in 2005, and war veterans since World War I.“The Nocturnists is thrilled to be partnering with the U.S. Library of Congress, the nation’s oldest federal cultural institution, for our ‘Stories from a Pandemic’ audio documentary storytelling project. We couldn’t imagine a better home for our audio library, which captures the raw emotions of numerous healthcare workers in the first few months of the COVID-19 pandemic and will serve as a historical document for future generations,” said Emily Silverman, a practicing internist and founder of The Nocturnists.Many contributors withheld their full names and other identifiers to provide a candid assessment of their working conditions, and the poignant accounts describe their personal risks, struggles and all-consuming frustrations while tending to the sick and dying.The collection reflects the daily scenes and emotional toll that played out in rural and urban hospitals across the nation in the early weeks of the pandemic, when the initial wave of cases overwhelmed emergency rooms, ICUs and morgues. The shortage of personal protective equipment (PPE) for medical staff, including masks and gloves, or ventilators for severely ill patients, added to the chaos in facilities already understaffed and overburdened.Arghavan Salles, an Iranian American bariatric surgeon in Stanford, California, had volunteered at an ICU unit in a New York City hospital, in what she described as an emotional “roller coaster ride,” at times fearing that the ill-fitting PPE would not protect her from contracting the virus.“The first couple of nights I was here were worse than I thought they would be in terms of how the patients were doing. I was very disappointed, I guess, really more upset about a couple of patients struggling to stay alive,” Salles says in one recording. “Who signed up to be rationing care and to have to decide whether someone’s mom, sister, or friend is going to get dialysis? I don’t think any one of us did.”For his part, Calvin Lambert, a first-year maternal-fetal medicine fellow in the Bronx, reflects on the disproportionate impact of the COVID-19 pandemic on African Americans and other communities of color and their general distrust of medical authorities.Lambert remembers treating a pregnant African American patient who became “irate, scared and tearful” as she refused to get nose-swabbed for the coronavirus, fearing that by doing so she would contract the virus.“Rather than be defensive, it’s up to us to be understanding, to understand where they’re coming from and to try to demystify and to rebuild that trust through (patient) education and empowerment,” Lambert says in the recording. “I cannot help but think about how the healthcare system has sometimes failed these groups and how we need to continue to restore their faith in us.”Jacqueline Flores, a family medicine practitioner in California, remembers the day back in March of 2020 when an ICU patient died of COVID-19 after being taken off life support. By then, the hospital had instituted a no-visitor policy, so her family could only say goodbye from a computer monitor wheeled into the room.“It just made me sad to think of all those people who are currently battling this disease, and their family members are not allowed into the room, in their final moments. Made me quite emotional today,” said Flores, whose hospital repurposed a unit for an anticipated surge in COVID-19 patients.In the last year, the COVID-19 pandemic has claimed the lives of more than 595,000 people in the U.S. alone, according to data compiled by Johns Hopkins University. This crisis has also created a pandemic of grief, as thousands have died alone in hospital beds due to visitor restrictions. Families have had to say goodbye to loved ones from the blue glow of their smartphone screens, and virtual funerals have become the new norm.Silverman, an internist at the Zuckerberg San Francisco General Hospital and assistant professor of medicine at the University of California in San Francisco, founded The Nocturnists to support the well-being of medical professionals through the healing power of storytelling and “to unearth complex truths about doctoring, build community and facilitate an environment of acceptance and healing,” according to the group’s website.Since its debut in 2016, The Nocturnists has produced over a dozen live storytelling shows in the Bay Area and New York City and is now in the fourth season of its podcast, which features selected stories from The Nocturnists’ live shows, an ongoing “Conversations” series with medical authors, and the two special audio documentary series, “Stories from a Pandemic” and “Black Voices in Healthcare”. The Nocturnists is currently creating a new audio documentary series for the fall of 2021 called “Shame in Medicine”, in collaboration with researchers from the “Shame and Medicine” project at the University of Essex and “The Shame Conversation” at Duke University.The timely collection of diaries joins the Library of Congress as the ongoing national vaccination campaign aims to fast track the reopening of schools, businesses and institutions, and a gradual return to normal pre-COVID-19 family life.Prior to receiving the gift from The Nocturnists, the Library of Congress started building new collections within the last year to document the global COVID-19 pandemic through photographs, posters, public health data, and artists’ responses to the health crisis.The Library of Congress is the world’s largest library, offering access to the creative record of the United States — and extensive materials from around the world — both on-site and online. It is the main research arm of the U.S. Congress and the home of the U.S. Copyright Office. Explore collections, reference services and other programs and plan a visit at loc.gov; access the official site for U.S. federal legislative information at congress.gov; and register creative works of authorship at copyright.gov.